Russell L. Carlisle, D.o.
NPI #1528459526 in Brandon, Mississippi
Provider Information
- NPI Number
- 1528459526
- Entity Type
- Organization
- Organization Name
- Russell L. Carlisle, D.o.
- Primary Specialty
- Clinic/Center - Primary Care
- Enumeration Date
- Feb 11, 2015
- Last Updated
- Feb 11, 2015
Practice Location
- Address
- 333 WILLOW RIDGE CV
- City
- Brandon
- State
- Mississippi
- ZIP Code
- 39047-8089
- Phone
- (601) 757-5791
Authorized Official
- Name
- DR. RUSSELL CARLISLE, D.O.
- Title
- OWNER
- Phone
- (601) 757-5791
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Primary Care — Primary Care |
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